RESEARCH PAPER The effectiveness of functional electrical stimulation for the treatment of shoulder subluxation and shoulder pain in hemiplegic patients: A randomized controlled trial ENGIN KOYUNCU, GU ¨ LDAL FUNDA NAKIPO  GLU-YU ¨ ZER, ASUMAN DO  GAN & NES ¸E O ¨ ZGIRGIN 5 th Physical Medicine and Rehabilitation Clinic, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey Accepted July 2009 Abstract Purpose. To investigate the effect of functional electrical stimulation (FES) for the treatment of shoulder subluxation and shoulder pain in hemiplegic patients. Method. A total of 50 hemiplegic patients with shoulder subluxation and shoulder pain were included in the study. The patients were randomly divided into the study and control groups. All patients were put on a rehabilitation program using conventional methods while the study group patients were additionally applied FES to supraspinatus and posterior deltoid muscles. The shoulder pain of all patients during resting, passive range of motion (PROM) and active range of motion (AROM) was measured with the visual analog scale (VAS) while the shoulder subluxation levels were evaluated with the classification developed by Van Langenberghe and by using the millimetric measurements on anteroposterior shoulder X-ray before and after the physical treatment and rehabilitation program and compared. Results. Comparison of the resting AROM vs. PROM VAS value changes showed no significant difference between the groups. There was a significant difference between the two groups for the amount of change in shoulder subluxation in favor of the study group. Conclusions. The results of our study have shown that applying FES treatment to the supraspinatus and posterior deltoid muscles in addition to conventional treatment when treating the subluxation in hemiplegic patients is more beneficial than conventional treatment by itself. Keywords: Hemiplegia, rehabilitation, shoulder subluxation, functional electrical stimulation Introduction Stroke due to paralysis and cognitive disturbance in the patients that survive is a major cause of disability [1]. Problems related to the upper extremity have a negative effect on rehabilitation in patients with stroke. Shoulder problems are the most important component of upper extremity complications in patients with stroke. Disturbed shoulder biomecha- nics lead to subluxation and shoulder pain [2]. Functional electrical stimulation (FES) is the stimulation of muscles with disturbed nerve function by an electrical current to achieve functional and beneficial movement. Various studies have examined the effectiveness of FES in shoulder subluxation and shoulder pain treatment [3–10]. For instance, Faghri et al. [3] evaluated the shoulder pain and shoulder subluxation using lateral range of motion (ROM) test and a modification of the distance measured from a single anterior–posterior radiograph of the shoulder described by Prevost and coworkers. Chantraine et al. evaluated shoulder pain and shoulder subluxation by visual analog scale (VAS) evaluation in resting, passive, and active range of motion (AROM) and Batz subluxation scale, respec- tively [4]. Yu et al. [5] evaluated the affected shoulder with Brief Pain Inventory and a vertical distance between the most inferolateral point on the clavicular portion of the acromioclavicular joint and the center of the humeral head. Different from these Correspondence: Gu ¨ ldal Funda Nakipo glu-Yu ¨ zer, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey. E-mail: g_nakipoglu@yahoo.com Disability and Rehabilitation, 2010; 32(7): 560–566 ISSN 0963-8288 print/ISSN 1464-5165 online ª 2010 Informa UK Ltd. DOI: 10.3109/09638280903183811